Gastrointestinal cancers are rising dramatically in people under 50
According to a review published Thursday in JAMA, gastrointestinal cancers have become the fastest-growing type of cancers diagnosed in adults younger than 50 in the U.S.
The review, one of the most comprehensive looks at gastrointestinal cancer trends, summarized the findings of major international and U.S. cancer databases, plus 115 papers on gastrointestinal cancers published from January 2014 to March 2025.
The authors underscore the need for people to follow the screening guidelines for colorectal cancer, which suggest that people with an average risk start screening — usually a colonoscopy or stool test — at age 45. Since doctors don't routinely screen for pancreatic, stomach and esophageal cancers in the U.S., the authors also call for new ways to screen more people for these cancers.
'This really points to the importance of trying to improve screening and early detection,' said Dr. Kimmie Ng, the review's co-author and director of the Young-Onset Colorectal Cancer Center at Dana-Farber Cancer Institute.
According to the review, colorectal cancer is by far the most common early-onset gastrointestinal cancer, with nearly 185,000 cases reported worldwide in 2022 and nearly 21,000 cases reported that same year in the U.S. Diagnoses in the U.S. have risen 2% annually in people younger than 50 since 2011, according to the American Cancer Society.
'It never used to happen in this age group, and now a very significant rise in 20-, 30- and 40-year-olds are getting colon cancer,' said Dr. John Marshall, chief medical consultant at the nonprofit Colorectal Cancer Alliance, who was not involved in the research. In one of the most high-profile examples, actor Chadwick Boseman was diagnosed with colon cancer in 2016 and died of the disease four years later at age 43.
Early-onset cases of pancreatic, stomach and esophageal cancers are also rising, according to the new study. Previous research has shown a disproportionate share of those gastrointestinal cancer diagnoses were among Black and Hispanic people. Pancreatic cancer is among the deadliest forms of cancer, with just 13% of patients surviving five years after their diagnosis.
Because colorectal cancer is the most common, doctors said they have a better grasp of what might be contributing to these early-onset cases compared with others.
'If we can understand what's going on in colorectal [cancer], I think it would really provide a lot of guidance to help us understand the other GI tract cancers,' said Dr. Scott Kopetz, a professor of gastrointestinal medical oncology at the University of Texas MD Anderson Cancer Center.
Kopetz said there are likely multiple factors driving the increase in early-onset cases.
'The leading theory is that there is no single leading theory,' he said.
Ng's new review in JAMA suggests that most gastrointestinal cancers in people under 50 are associated with lifestyle factors such as obesity, lack of exercise, poor diet, cigarette smoking or alcohol consumption. One study included in the review found that women who consumed more sugar-sweetened beverages during adolescence had a higher risk of developing early-onset colorectal cancer.
'It's really what people were doing or exposed to when they were infants, children, adolescents that is probably contributing to their risk of developing cancer as a young adult,' Ng said.
Health Secretary Robert F. Kennedy Jr. has been vocal about the association between sugary beverages and health issues, including cancer. On Wednesday, President Donald Trump said Coca-Cola will start being made with cane sugar rather than corn syrup in the U.S., but the company did not commit to the change when asked about it by NBC News.
Marshall said he suspects the rise in early-onset colorectal cancer could have something to do with changes in people's gut microbiomes — the bacteria that live in our gastrointestinal tracts. Diet, antibiotic use, microplastics and exposure to environmental chemicals likely all influence a person's gut bacteria, but scientists still don't have a clear understanding of what a healthy microbiome looks like nor how it affects our health. That is a booming area of research.
Ng's review also found that 15% to 30% of people with early-onset gastrointestinal cancer carry hereditary genetic mutations that may have predisposed them to getting cancer at a young age. Because of that, she said, 'we do recommend that all young patients diagnosed under the age of 50 undergo testing for hereditary conditions.'
Overall survival rates for gastrointestinal cancers have gotten better over time, due to improvements in treatment and screening. But Ng's review found that younger patients often have worse outcomes, despite typically receiving more treatments, including more surgery, radiation and aggressive combinations of chemotherapy, she said.
One reason could be that primary care doctors may overlook symptoms such as abdominal pain, constipation, heartburn or reflux in younger patients, thereby delaying their diagnoses.
'My personal feeling is that it's because we're finding them at a more advanced stage, because people don't really think of colon or other GI cancers when they see a young person with these nonspecific complaints,' said Dr. Howard Hochster, director of gastrointestinal oncology at Rutgers Cancer Institute and RWJBarnabas Health in New Jersey.
But Ng said that even after controlling for the stage at which patients are diagnosed, young people still seem to have worse survival rates.
'This makes us wonder as researchers whether that means that the cancers that develop in younger people may be biologically different and more aggressive, or maybe less responsive to treatment,' she said.
This article was originally published on NBCNews.com
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Newsweek
20 hours ago
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Gastrointestinal Cancers Are Rising Among US Adults Under 50
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'As we've said from the start, we sincerely apologize to our customers and those affected and continue to focus on strengthening the resilience of our platform and the industry.' In response to CrowdStrike's criticisms, the UCSD researchers say they stand by their findings. The Azure outage that CrowdStrike noted, they point out, began the previous night and affected mostly the central US, while the outages they measured began at roughly midnight US east coast time on July 19—about the time when CrowdStrike's faulty update began crashing computers—and affected the entire country. (Microsoft did not immediately respond to a request for comment.) 'We are unaware of any other hypothesis that would explain such simultaneous geographically-distributed service outages inside hospital networks such as we see here' other than CrowdStrike's crash, writes UCSD computer science professor Stefan Savage, one of the paper's co-authors, in an email to WIRED. (JAMA declined to comment in response to CrowdStrike's criticisms.) In fact, the researchers describe their count of detected hospital disruptions as only a minimum estimate, not a measure of the real blast radius of CrowdStrike's crashes. That's in part because the researchers were only able to scan roughly a third of America's 6,000-plus hospitals, which would suggest that the true number of medical facilities affected may have been several times higher. The UCSD researchers' findings stemmed from a larger internet-scanning project they call Ransomwhere?, funded by the Advance Research Projects Agency for Health and launched in early 2024 with the intention of detecting hospitals' ransomware outages. As a result of that project, they were already probing US hospitals using the scanning tools ZMap and Censys when CrowdStrike's July 2024 calamity struck. For the 759 hospitals in which the researchers detected that a service was knocked offline on July 19, their scans also allowed them to analyze which specific services appeared to be down, using publicly available tools like Censys and the Lantern Project to identify different medical services, as well as manually checking some web-based services they could visit. They found that 202 hospitals experienced outages of services directly related to patients. Those services included staff portals used to view patient health records, fetal monitoring systems, tools for remote monitoring of patient care, secure document transfer systems that allow patients to be transferred to another hospital, 'pre-hospital' information systems like the tools that can share initial test results from an ambulance to an emergency room for patients requiring time-critical treatments, and the image storage and retrieval systems that are used to make scan results available to doctors and patients. 'If a patient was having a stroke and the radiologist needed to look at a scan image quickly, it would be much harder to get it from the CT scanner to the radiologist to read,' Dameff offers as one hypothetical example. The researchers also found that 212 hospitals had outages of 'operationally relevant' systems like staff scheduling platforms, bill payment systems, and tools for managing patient wait times. In another category of 'research relevant' services, the study found that 62 hospitals faced outages. The biggest fraction of outages in the researchers' findings was an 'other' category that included offline services that the researchers couldn't fully identify in their scans at 287 hospitals, suggesting that some of those, too, might have been uncounted patient-relevant services. 'Nothing in this paper says that someone's stroke got misdiagnosed or there was a delay in the care of someone getting life-saving antibiotics, for instance. But there might have been,' says Dameff. 'I think there's a lot of evidence of these types of disruptions. It would be hard to argue that people weren't impacted at a potentially pretty significant level.' The study's findings give a sprawling new sense of scope to anecdotal reports of how CrowdStrike's outage affected medical facilities that already surfaced over the last year. WIRED reported at the time that Baylor hospital network, a major nonprofit health care system, and Quest Diagnostics were both unable to process routine bloodwork. The Boston-area hospital system Mass General Brigham reportedly had to bring 45,000 of its PCs back online, each of which required a manual fix that took 15 to 20 minutes. In their study, researchers also tried to roughly measure the length of downtime of the hospital services affected by the CrowdStrike outage, and found that most recovered relatively quickly: About 58 percent of the hospital services were back online within six hours, and only 8 percent or so took more than 48 hours to recover. That's a far shorter disruption than the outages from actual cyberattacks that have hit hospitals, the researchers note: Mass-spreading malware attacks like NotPetya and WannaCry in 2017 as well as the Change Healthcare ransomware attack that struck the payment provider subsidiary of United Healthcare in early 2024 all shut down scores of hospitals across the US—or in the case of WannaCry, the United Kingdom—for days or weeks in some cases. But the effects of the CrowdStrike debacle nonetheless deserve to be compared to those intentionally inflicted digital disasters for hospitals, the researchers argue. 'The duration of the downtimes is different, but the breadth, the number of hospitals affected across the entire country, the scale, the potential intensity of the disruption is similar,' says Jeffrey Tully, a pediatrician, anesthesiologist, and cybersecurity researcher who coauthored the study. A map showing the duration of the apparent downtime of detected medical service outages in hospitals across the US. Courtesy of UCSD and JAMA Network Open A delay of hours, or even minutes, can increase mortality rates for heart attack and stroke patients, says Josh Corman, a cybersecurity researcher with a focus on medical cybersecurity at the Institute for Security and Technology and former CISA staffer who reviewed the UCSD study. That means that even a shorter-duration outage in patient related services across hundreds of hospitals could have concrete and seriously harmful—if hard to measure—consequences. Aside from drawing a first estimate of the possible toll on patients' health in this single incident, the UCSD team emphasizes that the real work of their study is to show that, with the right tools, it's possible to monitor and learn from these mass medical network outages. The result may be a better sense of how to prevent—or in the case of more intentional downtime from cyberattacks and ransomware—protect hospitals from experiencing them in the future.
